Chronic Obstructive Pulmonary Disease Clinical Trial
Official title:
Iron and Chronic Obstructive Pulmonary Disease (COPD) Exercise Trial
This phase II single centre, double blind, placebo-controlled, randomised trial aims to test the hypothesis that intravenous iron improves exercise performance in Chronic Obstructive Pulmonary Disease (COPD) as measured by constant rate cycle ergometry.
Iron deficiency (ID) is one of the most common nutritional deficiencies affecting humans.
Chronic diseases, including COPD, are commonly complicated by iron deficiency anaemia (IDA).
It has been well documented that there is an association between both ID and anaemia and
reduced exercise capacity. It has been postulated that addressing this ID may be a novel
approach to improve exercise capacity and quality of life.
The ECLIPSE cohort found that the prevalence of anaemia in patients with COPD is 19% and is
associated with functional limitation and poor outcomes; similarly Nickol et al (2015) found
ID to be prevalent in 17.7% of patients with COPD.
Barberan-Garcia et al (2015) evaluated the relationship between Non-anaemic iron deficiency
(NAID) and aerobic capacity in seventy COPD patients before and after an 8 week high
intensity endurance exercise training programme. Endurance time was assessed as endurance
time during constant work rate exercise testing at 80% of oxygen consumption (VO2) peak. At
baseline it was noted that the NAID group in comparison to the normal iron status group had
a lower exercise tolerance of approximately 90 seconds, which is close to normally reported
minimal clinical important difference (MCID's) for this test, P=0.007. After adjusting for
confounding variables with a multiple regression analysis it was shown that training induced
increase in aerobic exercise capacity was only found in the normal iron status group, with
the effect of training on exercise tolerance being lower in the NAID (P=0.041).
Exercise capacity in COPD is strongly linked to outcome measures and mortality. The benefit
of correcting NAID in COPD subjects would be to achieve an increase in exercise endurance
and thus an improvement in Quality of Life (QoL). Currently there is no standard treatment
for NAID in COPD, so this pilot, randomised, double-blind, placebo-controlled trial will
attempt to answer this question.
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